A resident must receive nursing care and treatment, personal and custodial care, and supervision based on individual needs and preferences as identified in the comprehensive resident assessment and plan of care as described in parts 4658.0400 and 4658.0405. A nursing home resident must be out of bed as much as possible unless there is a written order from the attending physician that the resident must remain in bed or the resident prefers to remain in bed.
The criteria for determining adequate and proper care include:
evidence of adequate care and kind and considerate treatment at all times. Privacy must be respected and safeguarded;
clean skin and freedom from offensive odors. A bathing plan must be part of each resident's plan of care. A resident whose condition requires that the resident remain in bed must be given a complete bath at least every other day and more often as indicated. An incontinent resident must be checked at least every two hours, and must receive perineal care following each episode of incontinence. Clean linens or clothing must be provided promptly each time the bed or clothing is soiled. Perineal care includes the washing and drying of the perineal area. Pads or diapers must be used to keep the bed dry and for the resident's comfort. Special attention must be given to the skin to prevent irritation. Rubber, plastic, or other types of protectors must be kept clean, be completely covered, and not come in direct contact with the resident. Soiled linen and clothing must be removed immediately from resident areas to prevent odors;
a shampoo at least weekly and assistance with daily hair grooming as needed;
assistance with or supervision of shaving of all residents as necessary to keep them clean and well-groomed;
assistance as needed with oral hygiene to keep the mouth, teeth, or dentures clean. Measures must be used to prevent dry, cracked lips;
proper care and attention to hands and feet. Fingernails and toenails must be kept clean and trimmed;
bed linen changed weekly, or more often as needed. Beds must be made daily and straightened as necessary;
clean clothing and a neat appearance. Residents must be dressed during the day whenever possible;
monitoring resident temperature, pulse, respiration, and blood pressure as often as indicated by the resident's condition but at least weekly; and
recording resident height and weight at the time of admission and weight at least monthly thereafter.
20 SR 303
October 2, 2013